US1308799A - Surgical instrument for besetting broken bones - Google Patents

Description

H. C. MASLAND. SURGICAL INSTRUMENT FOR RESETTING BROKEN BONES.

APPLICATION FILED FEB. 24, 1919. Patented July 8, 1919.

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H. C. MASLAND.

SURGICAL INSTRUMENT FOR RESETTING BROKEN BONES.

APPLICATION HLED FEB. 24. l9l9.

I/VVE/VTOI? By 'fiF k ATTORNEYS.

ml: cnLuMlllA ILANOGRAPII c0 WASHINGTON. n. c.

'varied, and so it is to be UNITED STATES PATENT OFFICE.

HARVEY C. MASLAND, OF PHILADELPHIA, PENNSYLVANIA.

SURGICAL INSTRUMENT FOR RESETTING BROKEN BONES.

To all whom it may concern:

-.Be it lmown that I, HARVEY C. MASLAND, a citizen of the United States, residing in the city and county of Philadelphia, State of Pennsylvania, have invented a new and useful Surgical Instrument for Resetting Broken'Bones, of which the following is a specification.

. Myinvention consists of a surgical instrument for resetting a broken hone, the same embodying a plurality of pairs of jaws which are adapted to tightly clamp the sections of the bone, means for imparting a variety of adjustments to said jaws in lateral, angular, and other directions, and means adapting each pair of jaws to said adjustment independent of each other.

It consists also of details of construction adapting theinstrument for the purposes and adjustments as above named.

The invention is satisfactorily illustrated in the accompanying drawings, but the important instrumentalities thereof may be understood that the invention is not limited to the specific details shown and described, as long as they are within the spirit or scope of the claims. Figure 1 represents a side elevation of a surgical instrument for resetting a broken bone embodying my invention.

. Fig. 2 represents a transverse section thereof on line 22 Fig. 1.

Fig, 3 represents a transverse section of a portion on line 3--3 Fig 2.

a Fig. 4 represents a side elevation of one portion of the instrument.

Fig. 5 represents a longitudinal section thereof.

Fig. 6 represents a section on line 6--6 Fig. 5.

Fig. 7 represents a perspective view of a clamping member of the instrument. Fig. 8 represents a perspective view of a pivotally connecting member of the opposite ban dles of the instrument.

Fig. 9 represents a perspective view of one of the clamping jaws of the instrument. Fig. 10 epresents a perspective view of the opposite clamping jaw. Fig. 11 represents a perspective view of the carrier of the jaw shown in Fig. 10. Fig. 12 represents a partial vertical section and partial side elevation of another form of one of the bone engaging jaws or clamps.

Fig. 13 represents a side elevation of the Specification of Letters Patent.

Patented July 8, 1919.

Application filed February 24, 1919. Serial No. 278,572.

members shown in Fig. 12 at a right angle thereto. I

Similar numerals of reference indicate corresponding parts in the figures. Referring to the drawings,

1 designates a tube in a portion of which is fitted telescopically the bar 2, the bore of said tube and the exterior of said bar being of angular form whereby said bar is prevented from turning in the tube while it is capable of being moved in opposite directions in said tube.

One end of said tube is formed or pro vided with the jaw '3 and on the end of the bar opposite to said jaw 3 is the arm 4 with which is connected the jaw 5 which as is evident is opposite to the jaw 3, the two jaws 3 and 5 being adapted to clamp a section of a broken bone to be reset.

' In order to operate the bar 2 in opposite directions and so adjust the jaws 3 and 5 relatively to each other and t0 the contours of the sections of the broken bone to be reset, the end of the bar 2 opposite to the arm 4: is continued by the screw shank 6 which is engaged by the interiorly threaded sleeve 7 which is freely fitted within the tube 1 and is connected with the rotatable head 8 which latter has connected with it the collar 9 which is swiveled to the collar 10, the latter being fixed to the exterior of the tube 1 by the screw 11, it being evident that by rotation of the head 8 rotary motion is imparted to the sleeve 7 and sliding motion is imparted to the shank 6 and the bar 2, whereby the jaw 5 is adapted to be operated to and from the jaw. 3.

It will be noticed that the parts thus far described are duplicated as will be seen in Fig. 1, so that the opposite sections of a broken bone may be clamped for the purpose of manipulating them in order to reset the sections, as will be hereinafter referred to. a

In order to connect the opposite tubes 1, I employ the divided collars or clamps 12 each of which is adapted to embrace a tube, and their terminal ends are provided with the screw 13 which is adapted to close the clamp tightly on the tube and to release the same.

Projecting outwardly from the sides of the clamp are the headed gudgeons or pins 14 on which are mounted the bifurcated ears 15 which extend inwardly from the tubular block or bracket 16, said ears having therein the open eyes 17 to eceive the shanks 14: of the gudgeons 14:, said shanks being flattened so that by properly manipulating the block the open ends of the eyes 1.7 which ends are narrow may pass over said shanks then by turning the block 16 the other portions of said eyes which are circular may be mounted on said shanks, thus connecting said block with the gudgeons 14 and consequently with the clamp 12 and tube 1,*permitting the block to turn on said gudge'ons to adjust the tubes 1, their appurtenances and consequently the pairs of jaws 3 and 5 relatively to each other, it being evident that the tubes may be placed parallel or angularly to each other and moved separately in longitudinal directions, this being due to their mountings on the blocks or brackets, thus adjusting each pair of jaws according to requirements.

Each bracket 16 has fitted in it the'angular end of the screw 18 which is connected therewith by the pin 19 which passes through the bracket and enters the end portion'of the screw 18, said pin being held in position by the resilient member or spring 2Q which at one end engages the head of said pin and has its other end secured to the bracket by the screw 21 or other suitable means.

It will be noticed in Fig, 1 that I employ two screws'lS arranged end for end, their threads being pitched respectively right and left and engaged by theturn buckle 22, it being noticed that by the rotation of the latter, the opposite tubes 1 may be spread apart or'brought together so as to adjust the jaws 3 and 5 to the positions of opposite sections of a broken bone to be reset, and the heads 8 may be rotated whereby the members of the pairs of jaws may close on the sections and tightly grip and clamp the same.

The 3 is an integral portion of the tube 1, but to this I do not limit myself, and

Q'the jaw 5 is separable from the arm 4, it

being connectible with the latter by means of the eyes 23 on said jaw 5, the same entering a recess '24: in the end of the arm 4 and being held therein by the stud 25 which passes through said eye into the adjacent portion of the arm,-said recess being closed eXteriorly by the plate 26 which prevents theentrance of foreign matters to the recms. This adapts said jaw 5 to oscillate permit ting it to accommodate itself to varying contours of bones with which it may contact. In Figs. 12, and 13, the jaw 5 is differently mounted on the arm 4 and connected therewithfrom that shown in Figs. 4 and 5.

In order to permit the arm 4 to slide or move in opposlte directions on the tube 1, the side of the latter is cut away in longitudinal direction forming a passage 27 in which the inner end of said arm may play separating brackets.

and likewise preventing turning of the bar 7 from the heads 8 and collars 9, to themdjustable arms 4: without fixed brackets or projections, so that the clamps or collars 12 may be moved freely to any position on the tubes 1 between said collars '9 and said adjustable arms 4;.

Each pair of jaws or clamp has an attachable separating mechanism capable of being placed at any position desired along the lengths of their carriers and maintained in such placement and adapting them to beseparatcd or approximated with relation to each other or used as levers in either a simple or combined, rotary, vertical, horizontal or an ular direction and position relatively to eaci other and capable of being clamped and self retained in such desired and attained directions and positions as is evident.

In performing an operation with this equipment the usual method of procedure is as follows:-

The fractured bone ends are first exposed for a sufiicient part of their length. The bone clamps without the connecting screw turnbuckle assembled, and with the, separating brackets slid up and clamped on the shaft out of the way, are clamped on the fractured bone ends at the chosen distances from each other. A screw turnbuckle assembly is now attached to the distal pair of These are now slid dow-nthe shaft as'close as possible to the jaws of the clamps. The upper or proximal brackets are now slid down and clamped to the shafts just above the assembled brackets to prevent any slipping of the assembled brackets in the manipulations of the clamps.

Grasping a clamp in .eachhand atthe upper or handle. end of the clamp, shafts, leverage, traction or rotation single orcombined is exercised as the condition demands to bring the fractured ends of the bone, into perfect apposition.

Should leverage not be suflic-ient to. distract the fractured ends easily, then the turnbuckle is operated to produce additional separation of the clamps and consequently of the bone ends.

-vV11en the irregularly fractured ends. of the bone are accurately coapted, then the lower or distal brackets are clamped to the shaft in the position they occupy. One or both of the upper or proximal brackets can then be loosened and slid upon the clampshaft to such a position that when its. screwturnbuckle assembly is attached, it Will occupy other than a parallel position to the lower screw turnbuckle assembly. The up perscrew turnbuckle is now attached and the turnbuckle turned to produce a tight adjustment. All brackets are clamped tight in their respective positions on the clamp shafts and so the bone clamps are made rigid and self retaining in the positions they occupy while the bone ends are accurately adjusted. The operator can now leave them and turn to the other procedures necessary to fasten the bone ends permanently to each other. The bone clamps are then released and removed.

It will be seen that I have constructed a 'pair of clamps that, while utilizing the mechanical separators, also permits the clamps 'to be used as levers in the longitudinal direction and as tractors in the lateral and in a rotary movement with relation to each other.

I have provided means whereby when the bone ends are adjusted to each other, the clamps can be made rigid in the position they occupy, thereby retaining the bones in place, to allow the necessary further manipulations to be performed to permanently hold them in such position. This fixation of the clamps can be accomplished whether they I be tilted toward or away from each other, or

in different rotary'positions with regard to each other.

In the instruments heretofore used, the brackets on the clamps to which the separating mechanisms are attached must always be opposite each other, occupying a right angled position with relation to the shafts of These clamp shafts must occupy the same parallel planes to each other.

In my equipment, the separating mechanism is immediately detachable from the brackets on the clamp shafts. These brackets can be placed at any point along the shaft independent of each other, and where they might be most conveniently placed for the particular movement.

With the bracket sleeve rotatable on the cylinderical clamp shaft and the yoke movable in a plane at right angles to the bracket, I have practically universal motion, so that a the bracket can receive the screw turnbuckle assembly from any direction, either at right angles or any other angle to the shaft of the bone clamp.

The. separating mechanism can be attached to the brackets on the two clamp shafts at any angle with relation to the said shafts. The brackets can occupy any relative position to each other along the length of the shafts. My construction permits me to slip in as desired, screw turnbuckle assemblies of varying maximum and minimum lengths to meet the particular demand presenting itself.

The free untrammeled adjustability of separating mechanism-and its capability of being clamped rigid in any such position and the ability to-use my separating mechanism as a pliable fulcrum for any required hand leverage, traction or rotation simple or combined, are the major features of my equipment.

In my instrument I have a clean cylindrical shaft. No part of the mechanism becomes exposed with any adjustment. The proximal jaw shaft is the slida'ble member so that in any adjustment, it always has the support of the surrounding distal jaw shaft. The distal jaw clamp is double jawed and being external permits reinforcement without the addition of an excessive weight of metal. Weight is an important consideration in these instruments, as added weight increases the drag on the tissues.

When a bone is fractured the various muscles exercise a pull in their individual directions. The combined tendencies is to cause the bone ends to pass each other and so occupy different planes, traction being exercised in a longitudinal, a lateral, and a rotary direction, may be single, but most commonly combined.

Attention is directed to the duplication of certain members as heretofore stated. Said members consist of the turnbuckle 22, screws 18, blocks or brackets 16, clamps 12, and their appurtenances and connected with the tubes or cylinders 1, forming two sets of said members, the lower set extending at a right angle to said tubes or cylinders, while the upper set is shown at an inchnation to said tubes or cylinders, as illustrated in Fig. 1, said tubes or cylinders thus being supported at different places and adapted to be adjusted parallel with each other or at varying angles to each other according to the requirements of positions of the jaws or clamps.

It is well known that the ends of a fractured bone are serrat ed. In accurately fitting them the rotatability of the bones must be under the absolute control of the operator so my self adjusting jaw is adjustable in a longitudinal direction but not in a rotary direction, and there is no possibility of side slip save as the operator wills it.

It is evident that my instrument permits hand leverage. In this procedure the jaws may describe the arc of a circle, and a bone without my adjustment would move in the same circular sweep, and so produce undue strain on the soft tissues which my instrument avoids.

My automatic adjusting grip is capable of turning on the jaw clamp arm permitting an easement of the circular sweep, and-the bone retains in its movement a better longitudinal direction.

Having thus described my invention what I claim as new and desire to secure by Letters Patent is 1. An adjustable bone clamp formed of adjustable aws, a tubular shaft with which one of said jaws is connected, a slidable shaft within said tubular shaft with which the other jaw is connected, a sleeve in said tubular shaft adapted to engage said slidable shaft, a handlemounted on said tubular shaft, and a swivel connection for said handle and sleeve, said sliding shaft, sleeve and swiveled connection being contained in said tubular shaft and Wholly guarded by the same.

2. An adjustable bone clamp formed of adjustable jaws, a tubular shaft with which one of said jaws is connected, a slidable shaft in said tubular shaft having a threaded shank and being adapted to carry the other jaw, a handle mounted on the end of said tubular shaft, a rotatable sleeve in said handle and tubular shaft adapted to engage said threaded shank, said sleeve being secured to said handle, and a swiveled connection for said handle with said tubular shaft, said sliding shaft and its threaded shank beingadapted to be entirely inclosed in said tubular shaft. 7

3. An adjustable bone clamp formed of adjustable jaws, a tubular shaft with which one of said jaws is connected, a slidable bar within said handle with which the other jaw is connected, a threaded shank on said slidable bar, a swiveled sleeve in said tubular handle adapted to engage said shank to move it without rotation, a handle with "which said sleeve is connected, a collar swiveled to said handle and being secured to said tubular shaft whereby sald sleeve is adapted to impart the slidable non-rotary motions to said threaded shank and conse quently to said bar.

4. An adjustable bone clamp formed of adjustable jaws, telescopic connected shafts adapted to'carry said jaws, a handle rotata'bly mounted on the end of the tubular shaft, a threaded sleeve connected with said handle and rotatable within the tubular shaft upon a similarly threaded shank on the movable shaft and adapted to produce by the rotation of said handle and its connected threaded sleeve upon the movable shaft a forward and backward movement of the adjustable jaw on the latter.

5. An adjustable bone clamp formed of adjustable jaws, a tubular shaft adapted to carry one of said jaws, a slidable shaft within said tubular shaft adapted to carry the other jaw, a rotatable handle mounted on the end of said tubular shaft, a collar in said handle which is secured to said tubular shaft and has said handle swiveled to it, and

an interiorly threaded sleeve in said tubular shaft and adapted to enter said handle to whichit is secured so as to be rotated by "said handle, said slidable shaft having thereon a threaded shank which is adapted to engage with the threaded interior of said sleeve.

6. A plurality of telescopic fitted shafts, bone clamps on said shafts, an adjustable connecting and separating mechanism for said shafts, and devices on said mechanism connectible with the tubular shafts of said clamps capable of any difi'erent and independent adjustment on said shafts With relation to each other, irrespective of whether the said tubular shafts are parallel'or tilted at any angle toward each other.

7. Two flush cylindrical shafted bone clamps having an adjustable separating mechanism attachable to receiving devices on the said cylindrical shafts, said completely assembled separating mechanism allowing the said cylindric shafted bone clamps to move in, simple or compound vertical, horizontal, or rotary planes with re-' gard to each other.

8. Two adjustable bone clamps having an attachable mechanism mounted thereon to permit the said lbone clamps when holding the ends of fractured bones to be used as hand levers with relation to each other for the separation, approximation rotation or adjustment of said fractured bone ends to each other.

9. Two adjustable bone clamps having an attachable separating mechanism capable of being placedat any position desired along the length of said bone .clamp shafts and maintained in such placements and permits ting the said bone clamps to be separated or approximated with relation to each other or used as levers in either a simple or com- "bined rotary, vertical, or horizontal direction with relation to each other.

10. Two adjustable bone clamps having separating mechanisms attachable thereto permitting the said clamps to move in a simple or combined rotary vertical or horizontal plane with relation to each other and capable of being clamped and self retaining in such desired and attained position.

11. In a surgical instrument for resetting a broken bone, a pair of bone clamping jaws, and independent carriers for said pairs of jaws, said carriers being composed of separate members telescopically fitted to each other, and means for moving either of said members providing for the adjustment of said jaws on the bone and the firm clamping of the jaws in position on the latter.

12. In a surgical instrument for resetting carriers adapting the latter to be placed in parallel or angular positions and adjusted in lateral and longitudinal directions relatively to each other.

14. In a surgical instrument for resetting a broken bone, a plurality of pairs of bone clamping jaws, a plurality of carriers, one for each pair of such jaws, said carriers being composed each of members telescopically fitted to'each other, means for moving each of said members, and a device for adjustalbly coupling the plurality of said carriers, said coupling consisting of a screw, a turn buckle fitted thereto, and means for pivotally connecting said screw with said carriers.

15. In a surgical instrument for resetting a broken bone, a plurality of bone clamping jaws, a plurality of carriers, one for each pair of such jaws, said carriers being composed each of members telescopically fitted to each other, and an adjustable coupling for the plurality of said carriers, said couplings consisting of collars on said carriers, brackets pivotally mounted on said collars, screws connected respectively with said brackets, and a turnbuckle adapted to engage said screws.

Copies of this patent may be obtained for 16. In a surgical instrument for resetting a broken bone, a plurality of bone clamping jaws, a plurality of carriers, one for each pair of jaws, and an adjustable coupling for said carriers, said coupling consisting of collars on said carriers, brackets connected with said collars, the latter having thereon pins, and said brackets having thereon ears With open slots adapted to be pivotally mounted on said pins, right and left threaded screws connected respectively with the opposite brackets, and a turnbuckle adapted to engage said screws.

17. In a surgical instrument for resetting a broken bone, a plurality of pairs of bone clamping jaws, carriers for the latter, collars on said carriers, brackets pivotally mounted on said collars, screws adapted to be connected respectively with the opposite brackets, and a turnbuckle adapted to engage said screws, said brackets being provided with spring controlled pins which are adapted to engage said screws and connect the latter with said brackets.

HARVEY C. MASLAND. Witnesses JOHN A. WIEDERSHEIM, N. BUSSINGER.

five cents each, by addressing the Commissioner of Patents,

Washington, D. 0.

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